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The biomedical model Flashcards

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1
Q

what do models in psychology do?

3 points

A

models spell out:
* basic assumptions
* give order to the field under study
* provides a structured framework for scientific investigation

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2
Q

mental health models

what do models influence

4 points

A
  • what investigators observe
  • the questions they ask
  • the information they seek
  • how they interpret the data
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3
Q

what is the biological model

what does the biological model of metal disorders adopt?

A

a medical or biological perspective

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4
Q

biological model assumptions?

3 assumptions

A
  • mental disorders are biologically-based brain diseases
  • the underlying cause is organic
  • mental disorders reflect a disturbance of brain structure and/or function
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5
Q

what is the biological model?

A

the biological model argues that there is no meaningful distinction between mental and physical disease

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6
Q

from the 1970s what was maladaptive behaviour?

A

maladaptive behaviour increasingly considered to be a function of an interaction between biological, psychological and social factors

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7
Q

the biological model today

metal disorders

A

the idea that mental disorders are biologically-based brain diseases remains very influential

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8
Q

the biological model today

pharmacological agents

A

the biological model reflected the increase use of pharmacological agents in mental illnesses (e.g. depression, anxiety)

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9
Q

the biological model today

research evidence

A

there is a large body of research evidence correlating mental functions and brain activity

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10
Q

mental disorders: biological causes

neurotransmitter imbalance: altered production (or release)

A

altered production (or release) of neurotransmitter at synapses, over-or under-stimulating the target neuron

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11
Q

mental disorders: biological causes

neurotransmitter imbalance: altered reuptake (or degradation)

A

Altered reuptake (or degradation) of neurotransmitters, increasing or decreasing concentration at synapses

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12
Q

mental disorders: biological causes

neurotransmitter imbalance: alterations in neurotransmitter receptors

A

Alterations in neurotransmitter receptors, so that they are abnormally sensitive or insensitive

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13
Q

mental disorders: biological causes

psychotropic drugs

A

many drugs used to treat mental health disorders act at central (brain) synapses by increasing or decreasing neurotransmission at particular synapses

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14
Q

mental disorders: biological causes

what do psychotropic drugs influence?

A

psychotropic drugs used in the treatment of mental disorders influence synaptic transmission

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15
Q

mental disorders: biological causes

psychotropic drug mechanisms

3 points

A

mechanisms:
1. increased or decreased transmitter synthesis/release
2. increased or decreased transmitter re-uptake/inactivation
3. direct stimulation or inhibition of transmitter receptors

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16
Q

drugs and mental disorders

A

some drug discovery sheds light on mechanisms of disease - or understanding disease mechanisms allows rational drug design

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17
Q

amine hypothesis of depression

resperpine (drug)

A

in the 1950s the drug resperpine was approved to treat high blood pressure. but some patients appeared to become depressed or suicidal

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18
Q

amine hypothesis of depression

what was the drug resperpine doing to the body?

A

the drug was found to work by depleting nerve cells of amine neurotransmitters (e.g. seratonin & dopamine)

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19
Q

amine hypothesis of depression

iproniazis (drug)

3 points

A
  • late 1950s - anti-tuberculosis drug developed (iproniazis)
  • side-effects: euphoria, increased apetite and improved sleep
  • it increased amine neurotransmitters - used to treat depression
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20
Q

amine hypothesis of depression

what is depression caused by?

A

deficiency of amine neurotransmitters

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21
Q

how do anti-depressants work?

A

they work by correcting brain ‘amine deficiency’

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22
Q

amine hypothesis of depression

what are most antidepressants?

A
  • serotonin-selective reuptake inhibitors (SSRIs)
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23
Q

amine hypothesis of depression

what does blocking re-uptake of serotonin do?

A

increases its concentration at the synapses in the brain

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24
Q

amine hypothesis of depression

what was the most perscribed drug in the US

A

Zoloft (sertraline)

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25
# criticism of the amine hypothesis oversimplification | 4 points
* methodological problems * inconsistent findings * discredited serotonin hypothesis very small sample sizes, poor control of confounding variables
26
# other mental health disorders depression
symptoms due to deficiency of monoamine transmitters: noradrenaline, serotonin
27
# other mental health disorders schizophrenia
core psychotic symptoms such as delusions and hallucinations are due to excess brain dopamine
28
# other mental disorders obsessive-compulsive disorder (OCD)
symptoms caused by dysfunction in brain pathways regulated by serotonin
29
# biological models are complex issues with accounts of biological models of disease:
they are often highly simplistic and misleading
30
# biological models are complex issues with biological disease models:
they are highly complex and sophisticated and are supported by extensive research evidence spanning many decades: * genetics * structural and functional brain imaging * autopsy and neurodevelopmental studies * animal models
31
# hormones in mental disorders what does the endocrine system consist of?
glands that secrete hormones into the bloodstream
32
# hormones in mental disorders what are hormones?
chemical messengers that control bodily functions (e.g. sex, feeding)
33
# hormones in mental disorders what is the piturity gland?
the 'master gland' of the endocrine system
34
# hormones in mental disorders what is the piturity gland controlled by?
hypothalamus
35
# hormones in mental disorders hypothalamic-piturity-adrenal (HPA) axis
* over-active in stress, including chronic psychological stress * leads to persistent elevation of the stress hormone **cortisol** in the bloodstream * implicated in several psychological disorders (e.g. depression, anxiety)
36
# genetic vulnerability chromosomal abnormalities
complete or partial duplications/deletions (e.g. down syndrome: intellectual disability/dementia)
37
# genetic vulnerability single gene defects
abnormalities in particular genes (mutations) or disease associated normal variants (polymorphisms)
38
what are vulnerabilites to mental disorders?
they are ususally polygenic (influenced by multiple genes) * there is not usually a single gene for a particular mental disorder
39
# epigenetics what are epigenetics?
when a person's genetic code is fixed at birth, but genes can be switched 'on' or 'off' during life
40
# epigenetics how are genes silenced?
by adding molecular tags (methyl groups) to parts of the DNA strand
41
# epigenetics how is the pattern of gene methylation influenced?
it is influenced by the environment including early life experiences
42
# epigenetics what can adverse life experiences lead to
adverse life experiences (e.g. bullying, neglect) can lead to epigenetic changes that influence risk of mental health disorders in adulthood
43
# gene-environment interaction behaviour is not exclusively determined by?
the genes you inherit * psychiatric disease risk depends on both genetic and environmental factors
44
# biological model: treatment AIM
target the underlying biological dysfunction
45
# biological model: treatment ULTIMATE GOAL
discover precise therpeutic agents that the target disease process without causing harm
46
# biological model: treatment MOST TREATMENTS
pharmacological
47
# biological model: treatment OTHER TREATMENTS
brain stimulation, surgery
48
# insulin shock therapy who created the insulin shock therapy?
Manfred Sakel (1933)
49
# inslulin shock therapy what was insulin shock therapy used for?
mainly used for schizophrenia in the 1940s and 1950s
50
# insulin shock therapy risks of insulin shock therapy:
obesity, seizures, brain damage or death
51
# prefrontal leukotomy who created prefrontal leukotomy?
Egaz Moniz
52
# frontal lobotomy who created frontal lobotomy?
Walter Freeman who performed 3500 lobotomies
53
# frontal lobotomy what did frontal lobotomy do?
reduced emotional distress and improved challenging behaviour but left patients 'flat', passive and unemotional
54
# electroconvulsive therapy (ECT) what was ECT?
controlled induction of convulsive seizured under general anaesthesia
55
# ECT what does ECT affect?
affects numerous neurochemical (neurotransmitter) systems
56
# deep brain stimulation stimulation of area 25
stimulation of area 25 in the limbic lobe of the brain is associated with dramatic mood improvement in severe depression
57
# DBS what is deep brain stimulation used for?
used for severe treatment-resistant conditions (e.g. depression, OCD) * very expensive and carries risks associated with neurosurgery
58
# transcranial magnetic stimulation (TMS) what is transcranial magnetic stimulation used for?
used for treatment-resistant depression and anxiety disorder
59
# transcranial magnetic stimulation (TMS) how does TMS work?
electromagnetic coil delivers magnetic pulses to the brain - exact mechanism of action unclear
60
# pharmacological treatments psychotropic agents
any medication capable of affecting the mind, emotions and behaviour
61
# pharmacological treatments what are the most common forms of medical treatment for mental disorders? | 4 points
* antidepressants (low mood) * anxiolytics (anxiety) * antipsychotics/neuroleptics (psychosis) * mood stabilisers (bipolar disorder)
62
# antidepressant agents several types, acting on different neurotransmitters:
* patients do tend to improve * side effecis: nausea, nervousness, insomnia, sexual dysfunction
63
# antidepressant agents commonly perscribed antidepressants: | 4 types
* fluoxetine * sertraline * paroxetine * citalopram
64
# anti-anxiety drugs (anxiolytics) when are anxiolytics used?
they are used if guided self-help and cognitive-behavioural therapy fails
65
# anti-anxiety drugs (anxiolytics) anxiolytics examples:
benzodiazepines (valium, xanax) * sedative and muscle relaxing properties * causes drowsiness and lethargy * highly addictive, high relapse rates
66
# antipsychotic drugs (neuroleptics) what are neuroleptics used for?
they are used to treat psychotic disorders and act by blocking brain dopamine (and/or serotonin) receptors * effective in reducing delusions and hallucinations
67
# mood stabilisers what is lithuim used for?
used to treat bipolar affective disorder
68
KEY POINTS: biomedical model | 3
* biomedical model assumes that disorders have an organic or physical cause * many treatments have been based in the biomedical model, of which some are now discredited * treatments fall into 3 main categories: drugs, surgery and brain stimulation
69
KEY POINTS: Pharmacological interevntions | 3 points
* pharmacological interventions are by far the most common * they have revolutionalised the management and care of people with mental illnesses * however, they are not cures
70
# biomedical approach: advantages biomedical approach advantages: | 3 points
* suggests clear mechanism for most disorders: obvious improvement on 'supernatural' explanations * effective in delivering insights into disorders with a clearer biological base (e.g. alzheimer's disease) * drug treatment has revolutionised patient care: it is generally effective (and faster) than other therapies
71
# biological approach: advantages treatment based on the scientific method
in theory this means treatments should only be adopted if proven effective For example: antidepressants * Meta analysis suggested SSRI antidepressants were no more effective than placebo, except in severe cases * But another showed that patients are either responders or nonresponders
72
# research evidence: explained randomised control trial
ideally it should be 'double blind' RCT so that neither patient nor researcher know who is in the treatment (vs. placebo) groups
73
# research evidence: explained importance of meta analysis
a meta-analysis can be used to pool results from multiple trials
74
# biomedical approach: limitations assumes universality
* no room within its framework for social, psychological, or behavioural dimensions of disorders * **causality**: cause by-product of disorder? * **redctionism**: is psychology really biology?
75
# biomedical model: controversy CLAIM: Mental disorders are brain diseases caused by neurotransmitter dysregulation, genetic anomalies, and defects in brain structure and function
Yet, scientists have not identified a biological cause of, or even a reliable biomarker for any mental disorder
76
# biomedical model: controversy CLAIM: Psychotropic medications work by correcting the neurotransmitter imbalances that cause mental disorders
However, there is no credible evidence that mental disorders are caused by chemical imbalances, or that medicines work by correcting such imbalances
77
# biomedical model: controversy CLAIM: Biological psychiatry has made great progress in reducing the societal burden of mental disorder
However, mental disorders have become more chronic and severe, and the number of individuals disabled by their symptoms has steadily risen in recent decades
78
# biomedical model: controversy CLAIM: Educating the public that mental disorders are biologicallybased medical diseases reduces stigma
But, despite the public's increasing endorsement of biological causes and treatments, stigma remains and shows signs of worsening

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